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NPI Code Detail

MEDICARE: CARLY HILLEY WOLSTEIN DPT

MEDICARE: CARLY HILLEY WOLSTEIN DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist9317MT

General Provider Information

NPI Number : 1366813776
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLY HILLEY WOLSTEIN DPT
Provider Business Mailing Address
First Line : 850 HOLT DR
Second Line :
City : BIGFORK
State : MT
Zip : 59911-6218
Country : US
Telephone Number : 406-837-3255
Fax Number : 406-837-3256
Provider Business Practice Location Address
First Line : 850 HOLT DR
Second Line :
City : BIGFORK
State : MT
Zip : 59911-6218
Country : US
Telephone Number : 406-837-3255
Fax Number : 406-837-3256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2015
Last Update Date : 10/12/2015

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Directions to “ CARLY HILLEY WOLSTEIN DPT” Practice Location

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